Thursday, September 11, 2008 Talia asks

Q: My Sister

Hi,

I believe that my sister has paranoid schizophrenia which is not diagnosed. I have read a lot of articles which gives the symptoms that my sister have. She thinks almost everyone is out to get her. She used to trust me but lately, she thinks that I am involved as well. She always says that I know everything that other people are doing to her but I pretend not to know. She also stopped trusting my brother and sister-in-law. Additionally, she thinks my boyfriend is reading her emails and telling everyone what she's up to. She has only met him couple of times and known to her for about 6 months now. He doesn't even live close to me and thus we only see eachother once in 2 or 3 weeks. Also, she thinks lot of my friends are involved.

Her marriage has some problems these days and she lives seperately with her daughter. My neice who is 6 sees all this everyday. I want to help my sister and my neice but I don't know how. My sister doesn't think she has a problem and refused to go get help.

When she was going through lot of marriage issues, I conviced her to go see some help to cope with all the stress. She went and started taking medication but stopped it saying that it makes her gain weight and that she doesn;t have a problem that need medication.

Recently, I took her to a therapist who is a friend of mine...she went through the session and came back and told me that I know that the therapist will tell everything to my other friends since she a friend of mine.

I have sort of run out of my options of getting her help.... If anyone can give me any ideas or suggestions, I would greatly appreciate.

Thanks,

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Answers (2)

Christina Bruni, Health Guide

9/11/08 10:15am

Hi Talia,

Before I jump in to the usual advice I give everyone whose loved one lacks awareness that he or she has an illness, I will say that I admire your love for your sister and that you want to get her help so that she can be there for her daughter.

The key is to refrain from trying to convince her that she's sick and needs the meds. Up to 50 percent of the people with schizophrenia have anosognosia, a symptom of the schizophrenia that is the lack of awareness that one has an illness.

I suggest you read the Xavier Amador book, I Am Not Sick, I Don't Need Help. While you won't be able to convince her to take the meds because she has an illness, it is often possible to convince someone to take the meds for other reasons, like being able to achieve a life goal, such as returning to work or in this case, finding relief from her persecution. You and I know she's not being persecuted, but this is all too real to her, so you have to meet her where she is. I suspect that somewhere along the line, someone tried to hammer into her the idea that she's sick and needs to take medication. People who have anosognosia may take the medication at first, go along with it to pacify the other person or to get released from the hospital, and then they'll stop taking the meds again because they're convinced they don't need it.

So please, do not try to convince her she has an illness. Use the Amador technique of motivational interviewing to see what her goals are, develop a relationship of trust with her, and when you have an opening, ask her if you could suggest something that would help her achieve those goals. That's when you suggest medication.

Trust me, Amador's brother, Henry, had anosognosia for many years, and when Xavier began using the techniques outlined in the book, Henry became meedication compliant. Because the reality is, people will take psych meds even if they're not convinced they need them, if the evidence for achieving a life goal by taking them outweights their resistance.

I wish your sister to find relief, I really do.

Feel free to write back if you feel the need.

Regards,

Donna-1

9/13/08 11:05am

Christina's answer is excellent.

I was not med compliant for years and ended up in the hospital many times. Gradually it dawned on me that I did not want to keep living like that with really no life to speak of. I wanted to paint and be creative again. I wanted to be able to read a book again. And to walk through a crowd without paranoia seemed like the promise of heaven to me. So now, I am mostly compliant. I hate the weight gain, too, so I can empathize with your sister there. But Abilify and Geodon cause little or no weight gain for most people. She might be more willing to try the meds if she knew that.

Carolyn

Q: My Sister

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